As part of the CTSA consortium since 2009, the South Carolina Translational and Clinical Research Institute (SCTR) created an academic home for clinical and translational research in South Carolina that has transformed the research environment across the state with the goal of accelerating efficient translation of biomedical discoveries into improvements in human health. Headquartered at the Medical University of South Carolina (MUSC) in Charleston, SCTR created a ?front door? for access to statewide research resources, providing more than 700 direct consultations and innumerable website ?hits? each year. We successfully engaged local and regional stakeholder communities in facilitating and guiding research, implementation and dissemination activities. We catalyzed the formation of interdisciplinary research teams through innovative translational pilot projects and integrated training programs. We worked across the state and with national CTSA colleagues to streamline and improve efficiencies in research processes, including the development of a research service ordering and fulfillment system (SPARC) that is deployed within SCTR and four other CTSA hubs. A major focus of this renewal application is to advance Learning Health System (LHS) principles by: (a) providing real-time access to data to guide decision-making and continuous quality improvement efforts, (b) facilitating robust relationships with patients and other stakeholders to ensure clinical and translational research relevance, and (c) fostering a culture of collaboration, teamwork and adaptability. We will work with SCTR affiliates in South Carolina and collaborate with the CTSA Network to achieve the following specific aims: 1) Build on our clinical and translational research strengths to enrich and expand our integrated, statewide research environment and expand our CTSA Network collaborations; 2) Develop and implement high quality, innovative, flexible curricula and training experiences for all levels of the translational research workforce with a focus on enhancing diversity and advancing team science; 3) Promote community engagement throughout the translational research continuum and facilitate robust relationships with patients and other stakeholders to ensure CTR relevance; 4) Create an efficient enterprise-wide clinical and translational research ?Quality System? driven by continuous quality improvement and innovation; and 5) Promote the engagement of diverse populations across the lifespan in clinical and translational research.